Doubková Martina, Pospíšil Zdeněk, Skřičková Jana, Doubek Michael
Department of Pneumology and Phtiseology, Faculty of Medicine and University Hospital, Brno, Czech Republic.
Department of Mathematics and Statistics, Faculty of Science, Masaryk University, Brno, Czech Republic.
Clin Respir J. 2015 Oct;9(4):443-9. doi: 10.1111/crj.12160. Epub 2014 Jul 7.
Although sarcoidosis is a well-known disease, sarcoidosis patient outcome and the role of prognostic markers in everyday practice have not yet been well described. Therefore, the goal of the present study was to analyse the fate of sarcoidosis patients and the factors influencing the disease's behaviour in routine practice.
The study was a retrospective analysis of 306 consecutive patients (181 females and 125 males; median age 45 years) diagnosed with sarcoidosis in the years 2003-2012.
Through the use of uniparametric analysis, it was determined that the stage of the disease, organ involvement, CD4/CD8 ratio in the bronchoalveolar lavage fluid (BALF), serum and urine calcium levels, smoking, and pulmonary functions had a significant influence on spontaneous sarcoidosis resolution. Multiparametric analysis revealed that spontaneous resolution was significantly positively influenced by female gender, a less advanced disease stage, a higher CD4/CD8 ratio in the BALF, lymphocytosis in the BALF and normal pulmonary functions at diagnosis. During follow-up, only three patients died. The causes of death were respiratory failure with pneumonia (n = 2) and heart attack caused by sarcoidosis heart involvement (n = 1).
The data show sarcoidosis as a disorder with high variability in clinical and laboratory findings but with good general prognosis.
尽管结节病是一种广为人知的疾病，但结节病患者的预后以及预后标志物在日常医疗实践中的作用尚未得到充分描述。因此，本研究的目的是分析结节病患者的病情转归以及在常规医疗实践中影响该疾病发展的因素。
本研究对2003年至2012年期间连续诊断的306例结节病患者（181例女性和125例男性；中位年龄45岁）进行了回顾性分析。
通过单参数分析确定，疾病分期、器官受累情况、支气管肺泡灌洗液（BALF）中的CD4/CD8比值、血清和尿液钙水平、吸烟情况以及肺功能对结节病的自然缓解有显著影响。多参数分析显示，女性性别、疾病分期较轻、BALF中CD4/CD8比值较高、BALF中的淋巴细胞增多以及诊断时肺功能正常对自然缓解有显著的正向影响。在随访期间，仅有3例患者死亡。死亡原因分别为肺炎导致的呼吸衰竭（n = 2）和结节病累及心脏导致的心脏病发作（n = 1）。
数据表明，结节病在临床和实验室检查结果方面具有高度变异性，但总体预后良好。
